I can personally attest that they’re all very different… having had 4 orthotics made by 4 different doctors. Top teeth, bottom, both… some have made my jaw pain way worse but helped with breathing, some have done nothing… they’ve all protected my teeth from clenching but I’m gearing up for total joint replacement and wish I had saved thousands of dollars by avoiding all of the bad ones. There’s no real way to know since TMJ is so misunderstood and many doctors claim to be experts but have widely different approaches and understandings.
@@theTMJdoc didi, is it possible to reverse any damage caused to jaw by TMJ disorders (caused by a fall) especially when the problem is more than 30 years old....any advice will be most welcome 🙏🙏🙏
Someone on the tmj subreddit suggested your channel and I'm so glad they did, I love your release vids Pryia, they are exactly what my PT practitioner did to rehabilitate me after a root canal severely misaligned my jaw (due to a sports accident to the chin years ago). However, there were two exercises during my PT that I haven't seen you do. 1. relaxing a muscle by running a thumb under the jaw line and 2. applying pressure to the divot at the base of the skull. Have you ever done these releases for your patients? Also, I couldn't find you pdfs from you link. Is there a way I could download them? It's easier to remind myself to do the exercises with a paper on my desk then having to open YT all the time. Nevertheless, I really appreciate your videos, thank you!
Yes, I do the pressure under the jawline and at base of skull. I don't want to make videos on these because these are areas where more damage can be done if done incorrectly.
A picture doesn't really show much. It look similar to some other oral appliances and what makes it effective is the prescription built into it. Similar to eye glasses - they all look similar and fit the same way, but it's the specific prescription built into them that makes the difference.
Hi Dr Priya, as usual your videos are a wonderful source of information. I wonder if i can ask a quick question, i'm getting conflicting information on orthotics (night time use) from dentists local to me. One is stressing the need to restore (via orthotic) my worn out 'guides'... another is saying that the orthotic should be basically flat at the front to allow for movement and to not 'lock' the jaw into place. You say 'held' when your explaining the orthotic, so i'm imagining your practices are more aligned with the former right?! Thanks
Do you ever use palate expanders like the ALF or Vivos DNA appliance for adult patients who need more tongue space or have a trapped mandible from proper lack of expansion? Can tmj, jaw position, full body/mouth posture be restored in these types of patients by just using custom TMJD orthotics? At what point is an expander needed, or even Invisalign/braces ? I’ve had many consults, and a have received different potential treatment plans…which makes it harder to truly trust what is needed. Thanks for your help, love your videos.
Hi there! These questions are quite involved and not easy to answer through typing/text. If you'd like, you can email patientcare@tmjdentaldoc.com to set up a Zoom Meeting.
I have the same issue... tmj osteoarthritis... my splint often feels off and I was told the grinding at night is due to airway obstruction, so that's why I really want the expander treatment vs. a splint. My arch and jaws are too small for my tongue! So many different opinions and I don't know what yo do.
Thank you so much for these videos. I was recently diagnosed with TMJ after suffering with reoccurring & excruciatingly painful ear aches that would sometimes turn into infections & chronic sore throats too. Do you have any advice on questions we can ask our TMJ specialist to ensure they are the best provider for our individual needs? The treatments are costly & I just want to ensure I’m in the best care. My severe TMJ has caused a host of issues for me and it’s all so overwhelming how multifaceted the disorder is. Thank you.
There's not really any questions I can think of to ask because it can vary so much depending on who you see. If you'd like you can email patientcare@tmjdentaldoc.com to set up a zoom meeting with me so we can discuss your specific case.
Hi Dr Priya! I live in Boston, MA and it’s been hard to find a dentist that has the knowledge base and treatments that you do. I even saw an orofacial pain specialist and it was a really bad experience. But wondering if you have any suggestions on how to find an experienced TMJ specialist or have any colleague suggestions within New England- I’m willing to travel. Ty!!!
My TMJ dentist gave me the option of doing an orthotic or braces to fix my bite which he said would fix my TMJ. I opted for braces so I could straighten my teeth at the same time. I opted for Invisalign since I’m 42 and didn’t want the look of braces. $5K and a year and a half later and there is not a big difference in my TMJ. But my bite is noticeably better. I have to wear Invisalign retainers at night. Do Invisalign retainers work the same as an orthotic? Should I wear it more often then just overnight?
Dear dr. Mistry, do you maybe have any photo of the type of TMJ orthotic you make for your patients? Also, could you please explain why the orthotic shouldn't be bulky?
Great question but a picture won’t help. They look pretty similar but it’s the prescription built into orthotic that makes the difference. The best analogy I can think of is reading glasses vs prescription glasses. They look similar and are worn the same way, but it’s the prescription built into them that makes all the difference. Additionally, I have shown an orthotic on my TikTok account so feel free to follow me there and check out the videos 😊 TikTok: @the_tmj_doc
@@theTMJdoc Could you make a video about how do you make one of those? Like how do you take apropriate measurements (ideally on one of your patients, but I know this would be hard). It would be exceptionally helpful for me as I feel like every dentist I go to has no idea about this particular disorder and I'm on my own with it.
@@zowikthepet3910 hi it would be very difficult for me to make a video of that. If you have more questions you can always set up a zoom meeting with me by emailing patientcare@tmjdentaldoc.com
Hi Dr. Mistry, what are your thoughts on orthodontics for sleep clenching (as opposed to grinding)? Unfortunately, I developed a case of TMJD while going through Invisalign. I likely was a sleep clencher before, but having the additional retainers in my mouth really seemed to ramp up my clenching force while I slept. I was given a flat plane splint for my upper teeth to address my TMJD from my Orthodontist, but ultimately I started clenching even harder on the thick splint while I slept that it started making my TMJD significantly worse. I was advised by my orthodontist to stop using the appliance, but I'm still in a bit of a state with no solution. I'm curious if you've had to deal with patients who react adversely to types of orthodontics.
Hi Alan. I’ve just stumbled upon Dr. Mistry’s site and YOUR question…. I’m in exactly the same situation…. “Chewed” on my Invisalign’s for years and then couldn’t wear night guards to keep the new bite in place😕. It’s one big jaw-pippin’ mess. I wondered if you’ve found any help at all…..... Thanks!
@@caribarrett6175 Hi Cari! Agreed, TMJD is absolutely horrible. I can't say I'm out of the woods yet, but I can at least see light at the end of the tunnel. 🙂 With that said, I'll go into a bit more detail on things I've tried, and what's worked for me. It will be a bit long, but I hope it helps someone. As mentioned, I really developed a clenching issue after wearing Invisalign retainers for over a year. I probably did clench previously, but having retainers in my mouth really amplifies the force I use in my sleep. For me, symptoms have been primarily ear stuffiness, ear aches, feeling stiff at the temporomandibular joint, and some really horrific tinnitus (think multiple competing sounds on par with a fire alarm), and some pretty extreme sensitivity to sounds. I later started developing crackling sounds when I moved my jaw, which tipped me off this was TMJD instead of a purely ear problem. Quick list of things I tried, and what had worked for me: -Stopping wearing anything in my mouth at night. My symptoms are at their worst in the mornings where I wore a retainer in my sleep. This was the first thing I did that helped at all. For keeping my bite in place, I just decided to wear the retainer for the first part of the day instead of at night. -Trying a flat plane TMJD splint. Sounds like many people get help wearing this since it allows for free sliding of teeth if you grind, but for me I ended of clenching much harder. -Magnesium supplements before bed. Some people find it helps, but I didn't see any difference in bruxism. -Sleep study. Bruxism can be pretty common for people with sleep apnea. I didn't have sleep apnea, but I did take step for making sure I breathed more freely in my sleep. Positive thing my my health I'm sure, but no impact to my clenching. -Physical therapy. I've been seeing a physical therapist who has TMJ as a specialty. The exercises themselves include a lot of jaw and neck stretches. I found these helped with recovery on days I had a break from bad clenching, but couldn't make up for the damage I did on bad nights. A good part of recovery, but only a piece to the puzzle. -Masseter botox injections. Probably the first thing to truly help. I was told mine were about twice as developed as they really should be. Unfortunately, not cheap, and will take multiple rounds to normailize my masseters, but has been worth it if you have the money. Doesn't stop the clenching, but helps reduce the force and damage at that joint so it has a chance to heal. I've gone through two rounds, and will continue, since my right masseter still has some really significant bite force. -Visiting my physician. I followed up with my doctor, and we've recently been trying some prescription medication to see if something helps. So far I've tried a few weeks of muscle relaxers (cyclobenzaprine), which helped a bit, but not a complete solution. Currently trying an SSRI (Luvox) that some literature has shown to help some people with reduced bruxism. Still TBD if that is better than muscle relaxants. Your mileage may vary on the items above. For me, over the course of 8 months I've gone from being in pretty constant agony to slowly having more days where I feel almost completely normal.
@@alanmccarthy7578 I have tinnitus that I'm pretty sure is caused by TMJ and muscular issues with my neck. My tinnitus can be extremely loud and intense at times. It sounds like high-pitched feedback from microphones and kinda like electric sounding cymbals too. The majority of the time it's more mellow and not a huge problem. But man, when it's screaming for a few days I can't even sleep, I just crumble.
Great Video. So the main condition for an orthotic to truly work is to discover the ideal position of the mandible, so the orthotic can hold that position, and the muscles to relearn. If so, how to discover the ideal position of the mandible? Do we need to do myofascial release, and jaw manipulation in order to relax all the muscles, and just then try to create and adjust the orthotic? Otherwise, if you just simply apply an orthotic to a locked jaw with maybe the mandible muscles forcing it backwards or upwards and with disc displacement, then the orthotic will just hold that position, and not really help that much? What do you think?
I find this optimal position using the concepts of neuromuscular dentistry. Yes, an orthotic that doesn't have the optimal position could make things worse.
My local TMJ Dentist has recommended a daytime and nighttime TMJ orthotic. The total cost is $8,995. I desperately want relief from my TMJ symptoms but also do not have the $$$ to afford this. Curious if this is the going rate for a TMJ orthotic and what other people have paid.
The rates can vary a lot, depending on who you see, where you live, etc. My understanding is that many dentists across the nation charge $7500 for ONE custom neuromuscular TMJ Orthotic.
Have any of your patients had itchy ear canals associated with TMJ, my ears itchy first thing in the morning after clenching overnight then I use ear oil to help, it’s very uncomfortable
Personally, my my night guard did wonders for my TMJD I was getting ringing in the ears fullness in the ears what seem to be air infections humming in the ears, pressure in the ears pain in my head pain in my neck pain on my eyes and it all went away as soon as I started wearing my night guard I don’t know anything about the orthotic splints or whatever the other ones are but my dental night guard is just fine
That’s lovely and I’m so glad it helped!!! Every now and then I hear that a nightguard actually helps! Mostly I hear it does not… but I’m happy to hear it helped you 😊🙏🏼
I have constant pain all around one side of my throat/jaw/neck/ear; but ironically, they seem to disappear whenever I'm chewing food. Can I still have TMJ?
I’m enjoying your informative videos. Currently trying to decide between two neuromuscular dentists for the treatment of TMJD. One dentist uses a daytime support and a double device for nighttime support . The other dentist uses one orthotic 24/7 that is meant to be adjusted. Is one method of treatment more desirable than the other as far as producing favorable results? Thank you!
I'm sorry but it really depends on your condition. I don't feel comfortable giving you advice for your specific treatment over the internet and without examining you in person.
@@theTMJdoc I understand, thank you for reply. What determines whether someone gets a different nighttime support from orthotic day support? My jaw joints have remodeled, are retruded and compressed.
I got a night guard on my bottom teeth (made by a TMJ dentist) and it made my pain so much worse. I went ahead and got referred to another dentist and he said the night guard needs to be on the top teeth and it is 1200 dollars! I currently started TMJ physical therapy would this be enough ? Also is there anyone you recommend here in California? I am so afraid to try another night guard because the one I wore made my teeth start contacting in the front and now I am worried I am getting gum recession because of the contact.
Hello ma'am I have been watching your videos from past few months, your videos have helped me alot with my muscle pain. Ma'am but my dentist has not given me any orthotic to wear, and pain is also continuous only excercise gives me some relief ma'am can you pls help me with this Thank you ma'am
I currently have braces. Is there an option for my situation? Also, do you by any chance have a recommendation for a TMJ Dr in the Bay Area in California?
Hi Doctor! I currently wear a night time orthotic that’s was prescribed to me. In the morning I remove that night time orthotic to start my day and proceed with eating breakfast. With that said, is it normal for my bite to feel off for some time in the morning after I remove the night time orthotic? After some time , Throughout the day, I notice that my bite no longer feels off even when I proceed to each lunch and dinner. It’s just in the morning is when it feels off and eat breakfast.
@@theTMJdoc btw, i think a video on mandibular advancement devices would be pretty cool. Seeing as there's an association with nocturnal/sleep bruxism and UARS/apnea. I feel like these devices potentially may help both the sleep disordered breathing as well as serve as an occlusal splint. Just a thought.
i've been dealing with TMJ issues for the past 6 years with occasional popping/clicking in my left TMJ. i think my bite is a bit unbalanced since my rearmost molars on the left side don't touch. i've also gotten a MRI that showed i have arthritis in my TMJ. would a TMJ orthotic help given the advanced stage of my TMJ deterioration? i was also contemplating getting braces so i can fix my bite and hopefully have all of my teeth touch again.
My night guard made by my dentist to treat my tmj caused me an open bite and did not help to ease my tmj symptoms, instead made it worse..is this a rare situation?
@@theTMJdoc it was a nightguard made out of acrylic for both my upper and lower teeth with a hard brick only from the front so my teeth won’t touch at night
@@CIXFARM It’s really hard for me to say why this made it worse because there are so many factors that cause TMJ problems. Sorry, i wish I had a better answer.
I can’t get into the tmd specialist in my area until August but I’m in pain now, my dentist made me a splint, but it just keeps my back teeth apart. Is there anything better I can buy over the counter that you would recommend?
